In early May, the FDA approved once-daily dosing of Abbott’s powerhouseprotease inhibitor (PI) Kaletra (lopinavir plus booster ritonavir)—butonly for folks new to HIV meds. For now, the rest of you are stuck withthe twice-a-day: Once-daily hasn’t been tested in old-timers, and someHIV docs and treatment advocates worry that the PI’s blood levels willfall too low over 24 hours to work in folks with resistant virus. Andonce-daily dosing comes with a caution as big and bold as Kaletra’sfamously bright-orange capsule: The incidence of diarrhea may rise ifyou take Kaletra all at once rather than in two daily doses. Still, onedose is one less to worry about. And Abbott is reformulating thesoft-gel capsule into a tablet, hoping that the new tab will tableKaletra’s gastro side effects. The tablet will reduce the daily pilltotal from six to four and may avoid the PI’s take-with-foodrestriction (it’s being tested with and without). What’s more, it willomit one ingredient—fatty oleic acid—which Abbott’s George Hanna, MD, fingersfor the diarrhea and nausea. The new tabs are being tested in HIVersnew and old to meds. Last but not least, Abbott foresees a Norvir(ritonavir) remix, so HIVers who use Norvir to boost other PIs may beable to kick those icky side effects, too.
New Kaletra, Nice to Meet Ya